Provider Demographics
NPI:1396799706
Name:ROYCE, ROSEMARY (FNP)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:ROYCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ROMY
Other - Middle Name:
Other - Last Name:ROYCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:5700 100TH ST SW
Mailing Address - Street 2:MULTICARE HEALTH SYSTEM EXPRESS CLINIC
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2752
Mailing Address - Country:US
Mailing Address - Phone:253-584-2119
Mailing Address - Fax:
Practice Address - Street 1:2101 ROSECRANS AVE # 3230
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4749
Practice Address - Country:US
Practice Address - Phone:323-628-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN097442363LF0000X
WAAP30000708363LF0000X
WARN00072972163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8882791Medicare PIN